Vaginal Politics: DR Congo South Kivu chronicles August 15, 2010

What’s with my brain’s insistence on using Frank Sinatra’s “New York” as the default song-stuck-in-your-head soundtrack whenever I’m working in Democratic Republic of Congo?

Freshly arrived in the southern Kivu region of the Democratic Republic of Congo after 18 hours flight time and 5 hours drive from Kigali, Rwanda, I am pleased to report that Rwanda seems content in the wake of the recent “transparent” election on August 9th that allows President Paul Kagame to continue his program of healing and reunification (one version) or subversive neo-dictatorship, take your pick. On the way I read all manner of editorial and article on this election, leaving me pining for Camu’s imaginary political party for (forgive any misquote here) “people who are not sure they are correct”. The legacy of Belgian-mandated tribalism in this region is beyond the capacity of this well fed, safely raised American to pass judgement on, so I’ll stick with prayer that Kagame can heal his people. I will say this, despite USAID signs all over the country, the Chinese are all over Rwanda, laying electrical cable, engineering mountainside roads, investing in agribusiness…

Today’s drive from Kigali to the bordertown of Cyangugu was painless except for the usual money headache. Everyone here wants brand new USD, no tears, no wrinkles, 2006 mint. In Congo, the cash (and you can only use cash) needs to be small, and apparently, now in Rwanda, the USD cash needs to be big. I was ready for small – did not bring any big – inducing a polite, understated, sotto-voce full on caniption from the Rwandan driver about his tiny-tender, brand new USD $5′s fee. Thank goodness the Congolese relay driver had Benjamin in his wallet or I would have been driving halfway back to Kigali to wait for a bank to open on Monday.

Now on my 3rd return to Panzi Hospital www.panzihospitalbukavu.org, this time I am here to facilitate the regional needs assessment for a newly minted joint venture between Harvard Humanitarian Initiative www.hhi.harvard.edu and the Engender Health division of USAID www.engenderhealth.org designed to improve fistula care in this difficult and lately recognized disaster zone.

I’ll leave you with this quote from a 2007 treatise published by Dr. K. Ramsey of the United Nations Population Fund in the international journal of Gynecology and Obstetrics:

“Women in most developing countries still risk their lives and their health in childbirth despite the existence of life-saving interventions (the most obvious being cesarean section). In regions such as Africa and Asia, where approximately 95% of annual (worldwide) deaths occur, at least 20 women experience an obstetric morbidity (injurious complication of pregnancy that does not cause the mother to die) for every woman who dies…. The most devastating of these injuries is probably obstetric fistula, a condition that was virtually eliminated in industrialized countries nearly a century (A CENTURY) ago.”

International Journal of Gynecology and Obstetrics (2007) 99, 5130-5136.

Doesn’t that make you sad and furious and wanting to make it stop? Does me.